Is smoking a risk factor for low back pain in adolescents? A prospective cohort study
Is smoking a risk factor for low back pain in adolescents? A prospective cohort study
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DOI：
10.1097/brs.0b013e3181657d3c
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发表时间：
2008-03-01
期刊：
影响因子：
3
通讯作者：
Karppinen, Jaro
中科院分区：
文献类型：
--
作者：
Mikkonen, Paula;Leino-Arjas, Paeivi;Karppinen, Jaro
研究设计。一项青少年前瞻性队列研究。目的。评估青少年吸烟是否是年轻人腰痛（LBP）的危险因素。背景资料摘要。吸烟已被发现与成年人的腰痛有关。在青少年中进行的纵向研究很少。1986年芬兰北部出生队列的儿童在出生时和16岁时接受了检查，并在大约18岁时通过邮寄问卷进行了随访。主要终点是过去6个月期间的LBP。18岁时发生LBP， 16岁时没有。持续性病例在两个时间点均报告疼痛。采用Logistic回归分析分别评价吸烟暴露对男女任意LBP的影响，采用多项回归分析评价吸烟暴露对总人口中LBP严重程度（无LBP、“报告LBP”、“咨询LBP”）的影响。父母的社会经济地位、身体活动、体重指数和抑郁情绪被用作分析中的混杂因素。16岁时经常吸烟与女孩持续性腰痛相关（OR: 2.52; 95% CI: 1.40-4.53）。16岁时每日吸烟超过9支与持续性腰痛相关（2.57;1.03-6.46），并预测女孩的疼痛发生率（2.80;1.11-7.09）。在暴露-反应关系中，吸烟包年与女孩的偶发性和持续性腰痛相关，而这些关联在男孩中则不一致。18岁时吸烟包年与持续咨询LBP表现出暴露-反应关系，在暴露超过1.5包年的人群中，这种关系最强（5.82;1.39-24.42）。青少年时期经常吸烟与年轻成人的腰痛有关。吸烟包年在女孩中显示出暴露-反应关系。
Study Design. A prospective cohort study in adolescents.Objective. To evaluate whether smoking in adolescence is a risk factor of low back pain (LBP) among young adults.Summary of Background Data. Smoking has been found to associate with LBP among adults. Longitudinal studies performed in adolescents are few.Methods. The children belonging to the northern Finland Birth Cohort 1986 were examined at birth and at 16 years of age and followed up by a postal questionnaire at the age of approximately 18 years. The primary outcome was LBP during the past 6-month period. Incident cases reported LBP at 18 but not at 16 years. Persistent cases reported pain at both time points. Logistic regression analysis was used to evaluate the effect of smoking exposure on any LBP in both genders separately and multinomial regression analysis was used to evaluate the effect on the severity of LBP (No LBP, "Reporting LBP," "Consultation for LBP") in the total population. Parents' socioeconomic status, physical activity, body mass index, and depressive mood were used as confounders in the analyses.Results. Regular smoking at 16 years was associated with persistent LBP in girls (OR: 2.52; 95% CI: 1.40-4.53). Daily smoking of over 9 cigarettes at 16 was associated with persistent LBP (2.57; 1.03-6.46) and predicted incident pain in girls (2.80; 1.11-7.09). Pack-years of smoking were associated with incident and persistent LBP in the girls with an exposure-response relationship, whereas these associations were inconsistent in the boys. Pack-years of smoking at 18 years showed an exposure-response relationship with persistent Consultation for LBP, which was strongest in those with over 1.5 pack-years of exposure (5.82; 1.39-24.42).Conclusion. Regular smoking in adolescence was associated with LBP in young adults. Pack-years of smoking showed an exposure-response relationship among girls.